A Pakistani girl shot in the head by Pakistani Taliban assailants is "not out of the woods" but is doing well and has been able to stand for the first time, doctors at the British hospital treating her say.
Friday's medical briefing offered the first real indication of Malala Yousafzai's progress. Earlier briefings were quite limited out of respect for the girl's privacy.
Dave Rosser, medical director of the Queen Elizabeth Hospital in Birmingham, said she was now able to write and appeared to have memory recall despite her brain injuries.
Yousafzai, who was shot for vocally opposing the Pakistani Taliban, was flown to Birmingham on Monday to receive treatment after the attack earlier this month, which drew widespread international condemnation.
She has become a symbol of resistance to the group's effort to deny women education and other rights.
"It's clear that she's not out of the woods yet," Rosser said, adding that she had sustained a "very, very grave injury".
But he said she was "doing very well".
"In fact she was standing with some help for the first time this morning. She's communicating very freely, writing," he said.
Rosser said that Yousafzai was not able to speak because she had undergone a tracheotomy so she could breathe through a tube in her neck, an operation that was performed because her airways had been swollen by the bullet.
Yousafzai was shot as she left school in Swat, northwest of Islamabad.
The Pakistani Taliban said they targeted Yousafzai, a fierce advocate for girls' education, because she promoted "Western thinking" and was critical of the group.
The alleged organiser of the shooting was captured during a 2009 military offensive against the Taliban, but released after three months, two senior officials told Reuters news agency.
In a detailed statement about her injuries, Rosser said she had suffered fractures to the base of her skull and to the bone behind her left ear. Her left jawbone is also injured at its joint.
"Malala was shot at point-blank range," with the bullet hitting her left brow, Rosser said.
But instead of penetrating skull it travelled underneath the skin, the whole length of the side of her head and into her neck.
Damage to brain
Shock waves from the shot shattered the thinnest bone of her skull and fragments were driven into her brain.
Rosser said there was certainly physical damage to the brain but it was too early to tell whether that would affect any brain functions.
"She seems to be able to understand, she has some memory," he said.
"She's able to stand, she's got motor control ... [but] whether there are any subtle intellectual or memory deficits down the line, it's too early to say."
The hospital unit is expert in dealing with complex trauma cases and has treated hundreds of soldiers wounded in Afghanistan.
It has the world's largest single-floor critical care unit for patients with bullett wounds, burns, spinal damage and major head injuries.
Rosser said Yousafzai's treatment is likely to include reconstructive surgery to replace the damaged skull bone.
That surgery is unlikely to be carried out until for several weeks or even months, he said, since she is also fighting an infection that needs to be cured first.
"She's going to need a couple of weeks to rehabilitate, to make sure the infection is cleared up," he said.
The infection is probably related to the track of the bullet that grazed her head, Rosser said.
Yousafzai is in Britain alone. Hospital officials have been in touch with her family in Pakistan.
Officials in the Swat Valley originally said Yousafzai was 14 years old but officials at her school confirmed that her birthday was July 12, 1997, making her 15.
The shooting of Yousafzai, who campaigned for the right for women to have an education, has been denounced worldwide and by the Pakistani authorities, who have offered a reward of more than $100,000 for the capture of her attackers.